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Role of ultrasound in the follow-up of intra-abdominal testes post Fowler-Stephens orchiopexy.

Abstract：

OBJECTIVE:To review the role of various ultrasound (US) modalities in their ability to determine testicular viability in prepubertal testes following Fowler-Stephens orchiopexy (FSO). MATERIAL & METHODS:Our prospective study included all patients from the year 2012 to 2017 with intra-abdominal testes (IAT) who had one-stage or staged FSO in our tertiary centre. Follow-up was done at 6 months to assess testicular viability and testicular position by clinical examination, and this was correlated with conventional and Doppler US results then. RESULTS:This study included 28 IAT in total, who had one-stage (n = 16) and staged (n = 12) laparoscopic FSO. Median age was 1.27 years. Testicular atrophy was noted by clinical examination in 6 testes. In these 6 testes, conventional US confirmed an atrophic testicular nubbin and both Color Doppler US (CDU) and Power Doppler US (PDU) failed to show any parenchymal testicular vessels. Spectral Mode Analysis (SMA) also showed no significant arterial waveform. As for the remaining 22 viable testes by clinical examination, conventional US showed normal testicular morphology in all, while CDU and PDU confirmed adequate parenchymal blood flow in only 15 and 20 testes respectively. SMA revealed a normal arterial resistive index in only 21 testes. CONCLUSION:There is no evident role for US in the follow-up of prepubertal testes post-FSO as US results are strongly correlated to clinical examination findings. Blood flow assessment in prepubertal testes following FSO can be difficult, unclear and undetectable in cases. This can be due to the prepubertal testicular stage, technique or unrecognized testicular atrophy despite normal morphology. LEVEL OF EVIDENCE:Level IV: Case series with no comparison group.

journal_name

J Pediatr Surg

journal_title

Journal of pediatric surgery

authors

Elzeneini WM,Eldiasty SE,Nasser HM,Elzeneini AM

doi

10.1016/j.jpedsurg.2019.11.016

subject

Has Abstract

pub_date

2020-09-01 00:00:00

pages

1925-1932

issue

9

eissn

0022-3468

issn

1531-5037

pii

S0022-3468(19)30878-4

journal_volume

55

pub_type

杂志文章

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